Acne, commonly known as “pimples,” is a very common condition that can be controlled and treated. There is a lot to learn here, and the following is a brief discussion of acne onset factors, treatment and life considerations.
I. Factors in the development of acne.
1, hair follicle mouth blockage
2, androgen levels rise, sebum secretion increases
3. Overproliferation of Propionibacterium acnes
4, free fatty acids and other causes of inflammatory response
Second, treatment.
1. From the perspective of drug action mechanism.
(1) Regulate the epidermal keratinization process and dissolve acne: topical medications such as adapalene gel, retinoic acid ointment, isotretinoin gel, and peroxynivalenol gel also have the effect of dissolving keratin; oral medications such as isotretinoin.
(2) Medications that can kill Propionibacterium acnes: topical medications such as peroxyphenoyl gel, clindamycin gel, etc.; oral medications such as minocycline, doxycycline, etc.
(3) Anti-inflammatory drugs, topical drugs such as adapalene gel and vincristine ointment have certain anti-inflammatory effects; oral drugs such as tanshinone capsules and minocycline.
(4), anti-androgenic drugs such as: daing-35, spironolactone, etc.
2. In terms of lesion types.
(1) Whitehead acne, blackhead acne: mainly need to use drugs that regulate the epidermal keratinization process and dissolve acne, such as Adapalene gel, retinoic acid ointment. Many people may experience redness, flaking, itching and other discomforts in the early use of these drugs, so you can start with a low concentration. There are three concentrations of retinoic acid ointment on the market, 0.025%, 0.05% and 0.1%, which can be gradually transitioned from low to high concentrations. Adapalene gel is more irritating because the concentration is 0.1% and the dosage form is a gel, so it can be used twice a week in the early stage and gradually increase the frequency of use to once a night.
Because topical medication for acne is very slow to take effect, it takes several weeks to see results, and it is more effective if it is combined with physical therapy to remove the acne. However, it is best for the patient not to treat the acne themselves. One is that poor disinfection may cause secondary infection, and the other is that there is a greater risk of scarring if the method is improper and violent extrusion is used. In the hospital, the acne is usually sterilized and then squeezed out with acne needles or very fine electrocautery needles to open the acne. Fruit acid peels can also dissolve pimples, so it is possible to squeeze them after the peel. (The concentration of fruit acids used in fruit acid peels is high and needs to be performed in a regular hospital; skin care products containing fruit acids generally have a low concentration and can be used at home, but there are some precautions that are not discussed in detail here.)
(2) Red papules and pustules with inflammatory reactions: Anti-Propionibacterium acnes drugs and anti-inflammatory medications are needed, such as oral minocycline (a general course of treatment takes 6 weeks), tanshinone capsules, and topical peroxybenzoyl gel, clindamycin gel, etc. (Vitamin A acid cream, adapalene gel can also be used for mild to moderate inflammatory skin lesions)
(3) Cysts and nodules belong to moderate acne and may require oral isotretinoin in addition to the above mentioned medications. Isotretinoin is started at low doses and is taken for a longer period of time, which may take several months to a year. The drug has teratogenic effects and women need to stop taking it for more than 1 month before considering pregnancy. Other adverse effects are mainly dryness of the skin and mucous membranes, and a few people may have elevated transaminases and triglycerides. Large, fluctuating cysts can be irrigated and injected with glucocorticoids + antibiotics to help the lesions subside.
Note: Many of the above medications are prescription drugs and can only be used with a dermatologist’s prescription.
Third, life precautions.
1, do not stay up late, fried, sweet and greasy food eat less.
2, if women have prolonged menstrual cycle, low menstrual volume, etc., need to pay attention to whether there is polycystic ovary syndrome, recommended gynecological consultation.
3, pay attention to cleanliness, use a mild cleanser, do not use soap or scrubbing, oil-removing cleanser. Recommend amino acid cleanser, such as Punjabi Rice Essence and Fleur de Lis cleanser.
4, do not use cosmetics containing oil or powder, such as acne, BB cream, etc. Mask is not recommended. You can use external moisturizing lotion or spray.
5, pay attention to sun protection, especially for patients who use topical adapalene gel and retinoic acid cream (one is that retinoic acid cream is unstable when exposed to light, and the other is that this type of drug will make the stratum corneum thinner and may increase sensitivity to sunlight).